DHCS Director Michelle Baass discusses CalAIM implementation, care delivery, and Medi-Cal workforce at LA conference


Soraya Marashi


At the 2022 Los Angeles State of Reform Health Policy Conference, California Department of Health Care Services (DHCS) Director Michelle Baass discussed some of the latest and most notable developments in Medi-Cal during her Morning Keynote. 


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In particular, Baass highlighted the progress of CalAIM implementation and addressed Medi-Cal workforce development initiatives, as well as stakeholder concerns with Medi-Cal care delivery and payments.

Baass emphasized the importance of DHCS gaining regular feedback from the different entities involved in CalAIM as implementation continues in order to address problem areas with implementation so far and increase its efficiency.

“Before CalAIM was launched, the department traveled throughout the state and really listened to the problems and challenges facing both our partners and our members, and that’s how CalAIM was developed,” she said. “This fall, [we’re] also going to be launching a listening tour to hear how things are working on the ground, and working with our plans to convene county departments, providers, and the entities that are really integral to launching and implementing CalAIM. 

Through those experiences, we can refine and iterate [and] re-think what we’re launching and how we implement it in the coming years. CalAIM is going to take years to realize, everything’s not going to happen overnight, and we need to be receptive to the feedback [and] receptive to the learning.”

In the Q&A portion of Baass’s keynote, an audience member brought up concerns about private practice doctors being a historically underinvested cohort of Medi-Cal providers. Baass said the Equity and Practice Transformation Grants included in the 2022-2023 state budget will direct state resources to small practices in order to address these concerns and infrastructure needs coming out of the COVID-19 pandemic.

Baass said the state is working to develop the entire workforce of the Medi-Cal program to better serve members.

“I also think about some of the new workforce that we’re bringing into the Medi-Cal delivery system, community health workers, doulas, even peer support specialists, and how, with the addition of those workforces, we can use everybody supporting our Medi-Cal members to the best of their abilities,” she said.

Baass also highlighted the role of community health workers in discussions about things like health equity and the adverse impacts of climate change as California continues its efforts to transform the state health care system.

“I think about just trauma in general. That is one of the things that we are incorporating in terms of prevention and upstream efforts—I think about our community health worker benefit, and really the education and role that they can play with regard to upstream discussions in health education, with regard to the experiences of communities and families with climate change and the impacts that they may [experience]. 

Our whole goal [is] to go upstream and really take that population health management approach of [seeing the data that we have and how we design interventions that meet communities where they need to be].”

Another audience member brought up concerns with Medi-Cal payments to providers.

“Medi-Cal is a very complicated financing system,” Baass said in response. “I think one of the ways we’re thinking about this is the way we pay in our financial incentives in alignment, instead of paying for opportunities for flexibility, so that providers may have a little bit more flexibility in how they use their dollar versus just [increasing rates]. There are also other ways to ensure that our providers have the resources they need to provide care.”